1731 Beach Ave PLRS19-0154 Shower Pan PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0154
800 SEMINOLE ROAD ISSUED: 8/9/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 2/5/2020
MUST CALL INSPECTION • i • PM FOR + INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, ' AND OF ATLANTIC + CH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1731 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - SHOWER PAN $600.00
TYPE OF
CONSTRUCTION: NUMBER: GROUP:
169666 0000 NORTH ATLANTIC BCH
UNIT 1
COMPANY: + • •R '
COGBURN AND
WAKEFIELD ND 17C Ponte Vedra Ct Ponte Vedra Beach FL 32082
® OWNER: ADDRESS: CITY: STATE:
PARRISH ROBERT B 1731 BEACH AVE ATLANTIC BEACH FL 32233-5838
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF • .
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date:8/9/2019 1 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
I Ph(904)247-5826 Fax (904) 247-5845 PURS t9 _O' s4
JOB ADDRESS: ` e� f- PERNIIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 00 .
TYPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
** SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions ofr any other state or local law regulation construction or the performance of construction.
Property Owners Name !� O In �A e's"l Phone Number 6 3 l (�I 0�"
Plumbing Company Wc,�.�p i" �(��-c�i-cam( Q�cri"t I Office Phone 9e i - M-3N Fax
Co. Address: �Mm GA--JA- City State Zip Z2
License Holder(Print): �a State Certification/Registration# C4:7_4—1'-(?-71�G
Notarized Signature of License Holder
Before me s
TONI GINDLESPERGER
MY COMMISSION#FF 924951 Signature of Notary P is
r EXPIRES:October 6,2019
V, Bonded Thv Pictary Public Underwriters